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Thirty Years of HIV/AIDS: A New Challenge Is on the Horizon

Ron Simmons, Ph.D., who served as Executive Director of Us Helping Us, looks at how far we've come since the early days of HIV/AIDS and analyzes the implications of new infection statistics on prevention efforts.

Ed. Note: Champions of Change is a weekly initiative to highlight Americans who are making an impact in their communities and helping our country rise to meet the many challenges of the 21st century.

When I reflect on the 30th anniversary of the HIV epidemic, I am simply amazed. Amazed that I am still alive after living with AIDS for over 20 years and that there is an effective treatment for HIV that is one pill a day. I remember the early days of AIDS, there was no name for it—only fear. Doctors were afraid to touch you. Nurses were afraid to feed you. And your friends that tried to give you encouragement to not feel hopeless, died themselves from the disease. Today HIV/AIDS is a preventable and treatable disease. There is a lot least stigma and fear. The President of the United States speaks openly and affirmatively about ending the HIV/AIDS epidemic. In many jurisdictions, government funded programs provide a safety net of health care and support for people with the disease. So much has changed in 30 years, yet new challenges appear on the horizon.

One of the most serious challenges is the “paradigm shift” in HIV infection among Black men who have sex with men (MSM). Studies have found that the traditional paradigm, the theoretical model of a positive correlation between high HIV risk behavior and high HIV infection, may not be true for Black MSM. Such a paradigm shift would have a profound impact on the effectiveness of prevention efforts targeting Black MSM in the United States.

A 2010 behavioral surveillance study of 500 MSM in the District of Columbia found that 32% of the Black MSM 30 years and older and 12% of the Black MSM under 30 were HIV-infected. In comparison, 8% of the white MSM 30 years and older and none of the white MSM under 30 were HIV-infected. Yet, the Black MSM reported using condom 50% more and having fewer sex partners than white or Latino gay men. The Centers for Disease Control’s (CDC) 2005 five-city behavioral study of MSM found a similar discrepancy between sexual risk behavior and HIV prevalence among Black MSM, and the same paradox was recently reported in a surveillance study of Black MSM in Chicago.

Researchers believe that the discrepancy exists because the higher prevalence of HIV in the sexual networks of Black MSM results in their having a greater chance of exposure to HIV even though they use condoms more often than other MSM and the higher prevalence of sexual transmitted infections further facilitates the HIV transmission. Such a sexual ecology dynamic may also explain the high prevalence of HIV among Black women.

Ron Simmons, Ph.D., has served as the Executive Director or President/CEO of Us Helping Us for 18 years.